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Home My WebLink AboutPermit Electrical 2003-12-5 r/ .... . ~ ~ I. . , ';"- - I )- ~. ~ j , CITY OF ~h.~UNGFIELD, OREGON ,-,' . . ct as submitted has the tollowing 225 FlFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~CVl:~!j\'i'!\\L~689 not require specific land use rJJrroval. p ~~:;;:;,~;!~~I~; ,'~i!"F~~Z~:~'~ G<Z 53 m)!-;/11 s. T New Alteration or Extension Per Panel . ^ One Circuit $ 43.00 vr Spr;:.f7.,Jd EachAdditionalCircuitorwith $ 3.00 (IJ tI /t{ uP I t4f11 ~ J j"rvice or Feeder Permit . r'-~" --...---- --- '---"'- -,.... .....r- ~- -"-r-'-"'~'_._' E. :. ~~~~ne~~~~'2:!,~~~~~f}!tclu~e~ -::E.~~~ ~nsta!laEon~ AfT::\', i\ptJi":()I~gU:t""H\U u:a[]On U\i:it)' . 'I ' II.uIl,lN1!pmgalon ~_d_. $50.00 , ",10" 1- 'S'~gn!O tl. 'L"'Ii" ',II,:, me y" ,_. " .'. 'i'. 1 . U me Ig ling . ., 1-'. nr $ 50.00 1:~.JICnl,.I.. ,..' \-If,t,.~,,\~r,jl''J!\h:.)- OWNER INSTALLATION : 01\" ,;' L~~t~d~~er~~-"~I,d,ent!Wli''") -t,l~~ $ 25.00 The installation is being made on property I own whiCh')90. ' ,'I;umted'E~e!~Y{~,0,-,!~ercl~JI""'ym3 $ 45.00 is not intended for sale, lease or rent. CC:MTh7rri~mE1~-tric Pe~mit'Ii1:specti(in: Fe~~iSrS45.00 + Surcharges . .-.tn.... \ 'j- 'l....." .... nU\11L:cr"'-'-'-. '-~-<:;n."""- h~ 4.. i ISUBToTMHip ABOvE, . LEGAL DESCRIPTION /702 75""33 o blOt{ JOB DESCRlPTION ( 0 0 fh<..t t1 pO W/:::U. p~ 1.J/1 :s r7f'L- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ,--- .-.--- - -- -~,--. ,.-- ',"-"'- -.- -..-_."~:-_: :-1 2. CONfRACTOR INSTALlATION ONLY i t. ._ - ..... __ _.:__._.~_ _~_~_ _ ...;.. __"_~ Electrical Contractor 1.-,' ~ {;:'U 4?V c.-- Address fo. ;!:>Ol( ((I 3 '7 City };v 6, , Phone ') Y ( -(",ft -.P7'fC:. Expiration Date )5"<;35 ItJ/tf/'f S<17ff 5/0<1 Supervisor License Number Constr. Contr. Number Expiration Date I Signature of Supervising Electrician r;r/lo 4 1/ /1G ''1. Owners Name ( j/ li.Jr:5/. Address ZZ')' . r::.ffk. S" + City ~1C{l Phone Owners Signature: Inspection Request: 726-3769 Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder --f\ .-,.e;-- " - -- ..,~ ._-~- A. ~ .Ne~~.\'l."-sidCnt!al- Single'o~ J\.lnl~,-F~mill' per d;"eiUng' ..___ ..~ ~_. ._::!-..~_ _"""",-",-l:;;:,_.__... _ ._._. _...-. ___....., $106.00 $ 19.00 $50.00 ['. "'C"'''.' .....'..,_. ...: --:-.., - ,.. .., -"C-- - . B. i:~~rvicesor Feeders.. Inslallat!on, Alterations?f. Relocatio.n: "'-.-,--.- -" ~. ~-- ._.,~, ,. .. . .. . 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only i $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ~3 C. I Te;poraryS;~ices -;,~cFeeders'--.. ".' -.. .:.~,~'.," ,'-','.-,._'J ..:..I..:,.\{-..:. -_ __~,_ ._:." .:.._............~.~ _ __~ '_c,_ __. .. InstalhlmJfMltOSHA~r~~ME IF THE WORK 200 jWf~~~ ~NDER TillS PERMI\5f5DROT ~~: ~~~~&tJNXtBsOR IS AB'\rmOtJE~Wo~~o ANY 180 DAY PERIOD. Over 600 Amps or 1000 Volts see "B" above. iT", ---..--:-.--~--._- -..-...-- --.,.. T - ---- .-.- -- -1 D. ~~~anc!:~"'.cu!~___,_~__._.:.,>_.. _~~ _.'...",-... H ..I ...... - ..- -~._'_.._-_.-.~.__......_._. - ~-~- -.',. , . ~ 63 1./1(( 6'50 7371 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)IBuilding Forms/Electrical Permit Application 1..o3.doc . . CITY OF ~rKll'l'-'l'mLJJ Building/Combination Permit Status Issued PERMIT NO: COM2003-01212 ISSUED: 12/04/2003 APPLIED: 12/04/2003 EXPIRES: 06/04/2004 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6853 MAIN ST ASSESSOR'S PARCEL NO.: 1702353306204 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New PROJECT DESCRIPTION: 100 amp pedastal- encroachment permit lists 201 S 68th PI as location Commercial Owner: CITY OF SPRINGFIELD Address: 225 FIFTH STREET SPRINGFIELD OR 97477 Phone Number: 541-726-3753 I CONTRACTOR INFORMATION' Contractor Type Electrical Contractor TONY KOTH License 59748 I BUILDING INFORMATION' Expiration Date 05/04/2004 Phone 541-688-8996 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: _....1/ '''''i'\C~:. L E",~IDEV\Eml'MEWrrINFORMATlON , SETBAcKS cn~li S\-If>.L iLlIS \'b,,,.1! '0' Q i~IS \'<-" \l~OER n Ot>\~\) f " Frontyard Setbac;:Ui\-lORI1.r.O RIS f>.'Of>.t>\0 tlverlay Dist: Side 1 Setback: f>. ~~E~Cr.O \) 100 # Street Trees Rqd: Side 2 Setback: CO '00 Of>.'{ \lEI" Paved Drive Rqd: f>.~'{ IU Rearyard Setback: % of Lot Coverage: Solar Setbacks: REQUIRED PARKING Total: Handicapped: Compact: ....",;f"'\ Street Improvements: Storm Sewer Available: Special Instruction: ;01118.\": 1.....;....."..."-. ~ ,..... I PUBLIC IMPROVEMENTS' ' . UI~"'l.l '.,."llY . , . \"".,,_I.IU, ...1...., _ -', :-:_; ior ,'_ 1(;','" '. Sidewalk.Type:". . ,..' ....::. .~' I. ,"' \. ~ ',.. _f'\ r ;':"llt(:-.d,,1 ,', r:t.. _ ,-., . '~~OA'.-~S.;. ,I,' _',:rJ~ ';P?~!!sP~U~'Arai~s:,; 0090. \' .1 .." ~..,;.. ....: -~.. ,"s..;3 . .~...""r" ~, "'". "on C,,'I !i1~'. , ';." ,\' :j..\:,J_hl ~... ~:1 ' nU.1 -11-,.' II _ :.~~ _ r .,' ,. Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Pa2e 1 ofl . . CITY OF ~rKll~GI'lJ!,L1J Building/Combination Permit PERMIT NO: COM2003-01212 ISSUED: 12/04/2003 APPLIED: 12/04/2003 EXPIRES: 06/04/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Pair! , Fee Description + 10% Administratiye Fee + 7% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $6.30 $4.41 $63.00 12/4/03 12/4/03 12/4/03 1200200000000002553 1200200000000002553 1200200000000002553 Total Amount Paid $73.71 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Relluired Insnections , 1 Electric Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have carefnlly examined the completed application and do hereby certify tbat all information hereon is true and correct, and I further certify that any and 811 work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made ofany strncture without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-012 12 COM2003-012 12 COM2003-012 12 Payments: Type of Payment Check -~..Q.""_........ Wit. .'. ' ".q~. . ... . .,-..,~' Receipt #: 1200200000000002553 Description + 7% State Surcharge + 10% Administrative Fee Perm ServlFdr 200 amps or less Paid By LITE ELECTRIC Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department Public Works Department Date: 12/04/2003 2:58:52PM Amount Paid Item Total: 4.41 6.30 63.00 $73.71 How Received In Person Payment Total: Amount Paid $73.71 $73.71 . .